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This is VAERS ID 283775

Case Details

VAERS ID: 283775 (history)  
Age: 13.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2006-10-03
Onset:0000-00-00
Submitted: 2007-06-14
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Injection site swelling, Vaccine positive rechallenge
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA01256

Write-up: Information has been received from a registered nurse concerning a 13 year old female who on 03-OCT-2006 was vaccinated with a dose of GARDASIL. The nurse reported that the patient had received the first and second doses of GARDASIL (the second dose was two months late) and experienced swelling of the injection site arm. The patient sought unspecified medical attention. At the time of this report, the outcome was unknown. No product quality complaint was involved. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Additional information is not expected.


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